[TriLUG] help desk / trouble ticket software

[Chris Bullock]

We have outgrown our homegrown ticketing system, so we are looking to replace it 
with something else and wanted to get some recommendations:
Currently we are opening 20-40 tickets a day.  Looking for the following 
features.
Authentication with Active Directory
Ability to upload files/screenshots
have read only users
create "sites" where end users (managers) can view only their relevant "sites" 
tickets
Ability of other help desk users to "subscribe" to tickets
Create a ticket by emailing ticketing system
generate ticket via snmp trap
Reporting: user created, owner of the ticket, resolution time, site created 
under, etc,
Since we are healthcare we need to host this inhouse

It would also be nice if the same software had project tracking also.

thanks in advance
Chris